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PubMed1996

A study of female urinary incontinence in general practice. Demography, medical history, and clinical findings.

The aim of this study was to provide valid data on the demography, medical history and clinical findings among adult women presenting with urinary incontinence to general practitioners. In a rural community in Norway, all women > 20 years who consulted their general practitioner for urinary incontinence during a 3 year period were included in a prospective study. A thorough medical history and both a general and focused clinical examination were undertaken. Gynecological examination, stress provocation test, and 48 h frequency/volume chart and pad weighing test were also performed. 105 women were included (4.4% of women > 20 years in the total population). Mean age was 57 years, 64% were postmenopausal. A lot of comorbidity was reported. Duration of incontinence was > 5 years in 49%. By a severity index, 64% were classified as severe, 28% as moderate and 8% as having slight incontinence. 59% were using protective pads or garments. Mean leakage per 24 h was 31 g. 38% had significant genital prolapse. Contractility of the pelvic floor muscles was weak in 28%. Diagnostic classification revealed 50% stress incontinence, 10% urge and 40% mixed incontinence. 42% of the patients were a great deal or much bothered by their incontinence. Patients with stress incontinence were less bothered than others. Women presenting with urinary incontinence at a primary care level are prevalent, and often have significant incontinence. It is a challenge for the general practitioners to investigate and treat these patients optimally.

Adult↗
PubMed1998

A descriptive study of the demography, symptomology, management and outcome of the first 300 patients admitted to an independent hospice in Singapore.

The aims of this study were: 1) to describe the demography, symptomology, investigations conducted, non-pharmacological interventions and outcome of patients admitted to an inpatient hospice and 2) to identify the nursing and medical needs of terminally ill patients. Case-notes of the first 300 patients admitted to Dover Park Hospice were studied retrospectively. There were 159 men and 141 women making up 325 admissions. The racial distribution was: Chinese 95.0%, Malays 3.0%, Indians 1.3% and Others 0.6%. Two-thirds of the men (64.2%) had spouses while 44.7% of the women were widowed. The mean age was 64.7 years. The 3 most common cancers were lung (21.7%), colorectal (14.6%) and hepatobiliary (12.5%). A proportion of patients (39.5%) were not known to have any metastases. Most patients were referred from hospitals and the home-care based Hospice Care Association. The commonest reason for admission was for "terminal care" (57.2%). At admission, only 38% of the patients were aware of their diagnoses and prognosis while 30% did not know either. The average length of stay was 25 days with 7.7% of patients having more than one admission. The most common symptoms were pain, anorexia, breathlessness, insomnia, constipation and dry skin. Non-pharmacological interventions ranged from manual evacuation of the rectum to transfers to tertiary hospitals for surgery and other more invasive interventions. Many patients also attended day-care activities (23.1%). Outcome of the 325 admissions were as follows: went home 20%, died in the hospice 73.2%, went home to die 4.9% and others 1.8%.

Adult↗
PubMed1980

Public Health Service--Privacy Act of 1974. Notification of new system of records: "clinical research; records of subjects in intramural research, epidemiology, demography, and biometry studies on aging.".

In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to adopt a new system of records. "Clinical Research: Records of Subjects in Intramural Research, Epidemiology, Demography, and Biometry Studies on Aging." DHHS/NIH/NIA, 09-25-0142. These records will be used to accomplish scientific research conducted by intramural scientists employed by the National Institute on Aging (NIA), and by hospitals, universities, research centers and research foundation under contract with NIA. These research activities aim at determining the health status of individuals and changes in health status over time, the incidence and prevalence of certain diseases and problems of the aged in certain populations, and changes that take place as the individuals age who are under study.

Aging↗
PubMed1999

Effects of fire on the demography of the endangered, geophytic herb Silene spaldingii (Caryophyllaceae).

Understanding the effects of disturbances such as fire on plant demography helps elucidate the mechanisms that cause changes in community composition. I studied the effects of spring and fall fires on Silene spaldingii, an endangered perennial herb of grasslands in northwest Montana. Individual S. spaldingii plants were mapped, and size and flowering were recorded for 1 yr prior and 5 yr subsequent to the burn treatments. Enhanced seedling recruitment (70-410%) and a 22% increase in population size were the principal effects of fire on S. spaldingii, and fall burn plots had lower recruitment than spring burn plots. These effects were apparent for 2-3 yr following the treatments. Fire had no detectable effect on the survival of adults or recruits of S. spaldingii. Silene spaldingii exhibits prolonged dormancy in which plants do not produce aboveground vegetation for one to several consecutive years. Results suggest that fire has a positive effect on the population dynamics of S. spaldingii by removing litter and creating safe sites for recruitment. Prescribed fire should be an important tool for managing populations of this rare plant.

Journal Article↗
PubMed2003

[Demography and nesting ecology of green iguana, Iguana iguana (Squamata: Iguanidae), in 2 exploited populations in Depresión Momposina, Colombia].

We studied the demography and nesting ecology of two populations of Iguana iguana that face heavy exploitation and habitat modification in the Momposina Depression, Colombia. Lineal transect data was analyzed using the Fourier model to provide estimates of social group densities, which was found to differ both within and among populations (1.05-6.0 groups/ha). Mean group size and overall iguana density estimates varied between populations as well (1.5-13.7 iguanas/ha). The density estimates were far lower than those reported from more protected areas in Panama and Venezuela. Iguana densities were consistently higher in sites located along rivers (2.5 iguanas/group) than in sites along the margin of marshes, probably due to vegetational differences (1.5 iguanas/group). There was no correlation between density estimates and estimates of relative abundance (number of iguanas seen/hour/person) due to differing detectabilities of iguana groups among sites. The adult sex ratio (1:2.5 males:females) agreed well with other reports in the literature based upon observation of adult social groups, and probably results from the polygynous mating system in this species rather than a real demographic skew. Nesting in this population occurs from the end of January through March and hatching occurs between April and May. We monitored 34 nests, which suffered little vertebrate predation, perhaps due to the lack of a complete vertebrate fauna in this densely inhabited area, but nests suffered from inundation, cattle trampling, and infestation by phorid fly larvae. Clutch sizes in these populations were lower than all other published reports except for the iguana population on the highly xeric island of Curaçao, implying that adult females in our area are unusually small. We argue that this is more likely the result of the exploitation of these populations rather than an adaptive response to environmentally extreme conditions.

Animals↗
PubMed2004

[Medical demography from 2003 to 2025 present and future difficulties].

The present and future medical demography is determined by the French government, which decides the number of students in medicine and residents in medical specialties. There are too few students to replace retiring (65-year-old) practitioners. Medical needs may not be met in the coming 20 years. There is an urgent need to increase the number of medical students.

Adult↗
PubMed2005

Historical demography, selection, and coalescence of mitochondrial and nuclear (genes in Prochilodus species of northern South America.

Fishes of the genus Prochilodus are ecologically and commercially important, ubiquitous constituents of large river biota in South America. Recent ecologic and demographic studies indicate that these fishes exist in large, stable populations with adult census numbers exceeding one million individuals. Abundance data present a stark contrast to very low levels of genetic diversity (theta) and small effective population sizes (Ne) observed in a mitochondrial (mt) DNA dataset obtained for two species, Prochilodus mariae, and its putative sister taxon, Prochilodus rubrotaeniatus. Both species occupy major river drainages (Orinoco, Essequibo, and Negro) of northeastern South America. Disparity between expectations based on current abundance and life history information and observed genetic data in these lineages could result from historical demographic bottlenecks, or alternatively, natural selection (i.e., a mtDNA selective sweep). To ascertain underlying processes that affect mtDNA diversity in these species we compared theta and Ne estimates obtained from two, unlinked nuclear loci (calmodulin intron-4 and elongation factor-1alpha intron-6) using an approach based on coalescent theory. Genetic diversity and Ne estimated from mtDNA and nuclear sequences were uniformly low in P. rubrotaeniatus from the Rio Negro, suggesting that this population has encountered a historical bottleneck. For all P. mariae populations, theta and Ne based on nuclear sequences were comparable to expectations based on current adult census numbers and were significantly greater than mtDNA estimates, suggesting that a selective mtDNA sweep has occurred in this species. Comparative genetic analysis indicates that a suite of evolutionary processes involving historical demography and natural selection have influenced patterns of genetic variation and speciation in this important Neotropical fish group.

Animals↗
PubMedDate not supplied

Pediatric dentists: evolving demography.

The changing gender, racial and ethnic distribution of enrollees in advanced dental education programs is noted for the period 1983-1988. The evolving demography of pediatric dentistry provides positive role-models and represents an opportunity for better services to American youth.

Dentists, Women↗
PubMed1986

Demography of dialysis and transplantation in Europe, 1984. Report from the European Dialysis and Transplant Association Registry.

The demography of renal replacement therapy up until the close of 1984 in Europe is presented, based on return of individual patient questionnaires to the EDTA Registry. These were completed by 84.7% of known centres in 33 countries. Of 187,267 individually registered patients, 102,276 were known to be alive on defined forms of renal replacement therapy on 31 December 1984. The stock of patients alive on treatment by dialysis and transplantation in Europe continued to grow and exceeded 200 per million population in 14 European countries at the end of 1984. During the same year, 21,198 new patients were accepted for treatment in Europe, and crude acceptance rates for new patients exceeded 60 per million population in four countries. Acceptance rates for elderly patients continued to increase and age specific acceptance rates for males aged 65 and over exceeded 100 per million population in 12 countries. A total of 6802 renal transplants were reported during 1984. Regrafting accounted for a higher proportion of transplants in Nordic countries and in the United Kingdom, compared with other nations. During 1984 the total number of transplants reported to the Registry passed 50,000. The distribution of primary renal disease amongst adult patients commencing treatment in 1984 is presented. Amongst elderly patients commencing treatment, a strikingly high proportion have chronic renal failure of uncertain aetiology. Finally, causes of death have been analysed amongst adult patients dying during 1984, showing myocardial ischaemia and infarction to be the leading cause of mortality.

Adolescent↗
PubMed1986

Demography of dialysis and transplantation in children in Europe, 1984. Report from the European Dialysis and Transplant Association Registry.

The demography of treatment of children by renal replacement therapy in Europe is presented based on returns of individual patient questionnaires to the EDTA Registry up until the close of 1984. Patient questionnaires for 1984 were completed by all centres which defined themselves as special paediatric units. A total of 4983 patients have been reported to the Registry up until 31 December 1984 as having commenced renal replacement therapy under the age of 15. Of these, 1570 were known to be alive on a defined form of treatment at the end of 1984 and still under the age of 15. The numbers of these patients kept alive by different forms of treatment in individual countries are presented. The stock of patients aged under 15 at the end of 1984 exceeded 30 per million child population in Belgium, France, Iceland and Luxembourg. The highest age specific acceptance rates for children onto renal replacement therapy during 1984 were noted in those aged between 10 and 14 at first treatment. Age specific acceptance rates for children varied greatly between individual countries, and 18 countries reported no new patients under the age of 5 during 1984. Transplant activity in paediatric patients during 1984 has been analysed and results on regrafting presented. Proportional distribution of primary renal diseases amongst children commencing therapy in 1984 is shown according to age at start of treatment. Haemolytic uraemic syndrome was reported as the cause of end-stage renal failure in 12.0% of children commencing treatment under the age of 5, and 12.3% of children between 5 and 9. Finally, information on cause of death in paediatric patients dying during 1984 is presented, and shows cardiovascular disease was the leading cause of mortality.

Adolescent↗
PubMed1988

Demography of dialysis and transplantation in Europe in 1985 and 1986: trends over the previous decade. Report from the European Dialysis and Transplant Association Registry.

The demography of renal replacement therapy for 1985 and 1986 is presented, based on returns of individual patient questionnaires to the EDTA Registry, supplemented by some data from the centre questionnaire. Patient questionnaires for 1985 were received from 83% of known centres and for 1986 from 79% of known centres in 33 countries. Of 244,497 individually registered patients, 116,892 were known to be alive on defined forms of renal replacement therapy on 31 December 1985 and 121,755 on 31 December 1986. Countries covered by the EDTA Registry include one-third of the world's population on renal replacement therapy. Individual countries exemplify different strategies with variable proportional contributions from home haemodialysis, CAPD and transplantation, and varying levels of achievement in numbers of patients on treatment. Trends in patient populations demonstrate that standard risk patients (aged under 55 and non-diabetic) are mostly receiving treatment in countries with advanced programmes, whereas the growth in numbers of new patients is due largely to increase in the acceptance of high-risk patients (aged over 55 or with diabetes mellitus). These trends have implications for the future; predictions must take account of the variable mixture of standard and high-risk patients, the different results achieved in these categories and the rates at which the mixture between them is changing.

Europe↗
PubMed1984

Hemophilia in Sweden. Studies on demography of hemophilia and surgery in hemophilia and von Willebrand's disease.

Demography: All known hemophiliacs in Sweden, 564 cases, were subjected to a demographic survey in 1980. The ratio of hemophilia A/B was 81/19. The severe cases constituted 30% and the mild 54%. Mean and median ages for mild and moderate hemophiliacs did not differ from those of Swedish males but were approximately 10 years lower in the severe cases. The prevalence was 7 per 100,000 population. The incidence remained constant at 1.7 (+/- 0.1) per 10,000 live-born males in the period 1957-1978. Mortality: In the period 1957-1980, there was a substantial increase in the median age at death among 118 deceased hemophiliacs. This increase was most pronounced in severe hemophilia, from 19 to 50.5 years. Intracranial hemorrhage accounted for one third of the deaths. Six deaths were attributed to hepatic dysfunction caused by hepatitis. Age related deaths (ischemic heart disease and malignancy) increased from 8 % to 32 %. Longevity: Median life expectancy of hemophiliacs in Sweden increased faster than the median life expectancy of the male population. In the beginning of the century, severe hemophiliacs faced a median life expectancy of about 11 years which had increased to 58 years by 1969-1980. Median life expectancy in mild and moderate hemophilia was 72 years, only three and a half years less than the corresponding age for Swedish males. Surgery in hemophilia and von Willebrand's disease: Three hundred and twelve operations (225 in hemophilia and 87 in von Willebrand's disease) were performed on 180 patients (121 hemophiliacs) in the period 1956-1983 at the General Hospital in Malmö. During the first years reconstructive orthopedic surgery dominated among young, severely affected, hemophiliacs but in recent years surgical diseases unrelated to the bleeding disorders increased. Ninety-seven operations were indicated by ailments caused by the bleeding disorders, mainly hemophilic arthropathy and pseudotumours. In another 72 operations the bleeding disorders were considered a contributing factor, mainly gastric surgery for ulcers, hysterectomy indicated by menometrorrhagia and subdural hematomas. Reconstructive orthopedic surgery was almost exclusively performed in hemophilia but gastric surgery was more common in von Willebrand's disease. The operations claimed three fatalities. It was considered essential to extend the substitution therapy to at least two weeks, especially in orthopedic surgery and in severe hemophilia. Furthermore, it was of the utmost importance to have access to laboratory facilities for repeated determinations of VIII:C/IX:C in hemophilia, Duke bleeding time in von Willebrand's disease, and to exclude the presence of inhibitors.

Adolescent↗
PubMed1998

Distinctive demography, biology, and outcome of acute myeloid leukemia and myelodysplastic syndrome in children with Down syndrome: Children's Cancer Group Studies 2861 and 2891.

In recent pediatric trials of acute myeloid leukemia (AML), children with Down syndrome (DS) have had significantly more megakaryoblastic leukemia and have experienced better outcome than other children. To further characterize AML in DS, Children's Cancer Group Studies 2861 and 2891 prospectively studied demography, biology, and response in AML and myelodysplastic syndrome (MDS) of children with and without DS. These studies evaluated timing of induction therapy and compared postremission chemotherapy with marrow transplantation in 1,206 children. One-hundred eighteen (9.8%) had DS, a fourfold increase in 20 years. DS patients were younger, had lower white blood cell and platelet counts, more antecedent MDS, acute megakaryoblastic leukemia or undifferentiated AML, and an under-representation of chromosomal translocations (P < .001 for each variable). Four-year event-free survival in DS was 69% versus 35% in others (P < .001). Intensively timed induction conferred significantly higher mortality in DS patients; bone marrow transplantation offered no advantage. Conventional induction followed by chemotherapy achieved an 88%, 4-year, disease-free survival in DS patients versus 42% in others (P < .001). Megakaryoblastic leukemia was unfavorable in others but prognostically neutral in DS. AML in DS is demographically and biologically distinct from AML in other children. It is singularly responsive to conventional chemotherapy and may warrant even less therapy. The increasing proportion of DS patients with AML most likely reflects changes in attitudes about entering DS patients on AML trials and possibly increasing ability to distinguish megakaryoblastic leukemia from lymphoid leukemia.

Acute Disease↗
PubMed1998

Family demography in a remote rural community in Zambia.

A community survey was conducted in a remote rural area of Zambia by The Kasanka Trust whose aims in running a National Park are to include aid to the community living around its borders. Selected results have been extracted from a general report by the Kasanka Trust, including awareness of HIV infection and tuberculosis. The remarkable population dynamics found in this apparently impoverished, poorly served community is highlighted.

Adolescent↗